My journey in reversing pre-diabetes
I was diagnosed as pre-diabetes in 2019. Forward to May 23rd, 2023, Hemoglobin A1c jumped from 5.9 to 6.2.What is Hemoglobin A1c and why that number matters to our health? A1c is the percentage of red blood cells that carries glucose instead of oxygen.
Dr Boz TOP killer
| A1c Range | Diagnosis |
|---|---|
| 5.6 or less | Normal |
| 5.7 - 6.4 | Pre-diabetes |
| 6.5 or higher | Type 2 diabetes |
A huge drop in triglycerides also took place. In three months, it dropped from 201 to 81. Cholesterol dropped from 220 to 188. For my mom, her triglycerides dropped from 112 to 69. Her cholesterol dropped from 211 to 171. At 82, she takes 0 pills daily, not even the doctor prescribed Lipitor for high blood pressure pills. Our metabolic health has reversed in time.
Curing a sick patient is no different than curing a sick computer. You need to collect and analyze data systematically. You need to pinpoint the exact root cause. Only then the sick can be fixed properly. Working in the tech sector for many decades, I have worked and resolved complex hardware and software issues. Reversing pre-diabetes is just another problem solving at the office.
Looking back, I am extremely disappointed at the lack of guidances from the healthcare professionals. According to Dr Casey Means, patients are being destroyed because of the financial gains. Doctors are never taught about nutritions in medical schools. Most think metabolic diseases are progressive rather than curable. They are only trained to manage the conditions through drugs and procedures.
Calley & Casey Means: How Big Pharma Keeps You Sick, and the Dark Truth About Ozempic and the Pill
American Health Crisis Roundtable with doctors and nutritionists
Dr Boz This is how doctors really make money
Healthy Diet and Lifestyle Better Medicine than Pills and Surgery, Doctor Says
Dr Wiedeman view on the poor healthcare
Dietitians give BAD Diabetic Advice with Michelle Hurn, RD
Do we need a new Diabetes Association?
Thus I decided to share my experience and knowledge acquired through this journey. You can reverse pre-diabetes or Type 2 diabetes by changing diets. It's not easy for Asian people as our foods are carb heavy. But it's doable.
Root Cause
Eating too much simple carbohydrates lead to Type 2 diabetes and weight gain. When we are young and very active, the body handles high carb load effectively. As we age, the body metabolism slows down.
SugarMD reversing diabetes
Relationship between Carbohydrates and Weight Loss
I tried a Continuous Glucose Monitor
Important Blood Tests
A Fasting Glucose blood test is used to obtain Fasting Glucose number. Need to fast 12-hour before taking the test.| Fasting Glucose (mg/dL) | Diagnosis |
|---|---|
| 70-99 | Normal |
| 100-125 | Pre-diabetes |
| 126 or higher on 2 separate tests | Type 2 diabetes |
Beside OGTT, HOMA-IR blood test can be performed to check for insulant resistant.
Cholesterol numbers including Total Cholesterol, Triglycerides (fats in the bloodstream), HDL (good cholesterol) and LDL (bad cholesterol) are obtained from Fasting Lipid Panel blood test. Here is Dr Robert Lustig ultimate guide to the Cholesterol Panel results. Use Cardio Vascular Ratios below to determine the risk factor for coronary heart disease risk.
In a Spain study from 3 insurance companies, researchers discovered that Triglycerides to HDL ratio values > 2.75 in men and > 1.65 in women were found in the Metabolic Syndrome (Insulin Resistant)
| Total Cholesterol (mg/dL) | Diagnostic |
|---|---|
| Less than 200 | Normal |
| 200 - 239 | Borderline |
| 240 or higher | High |
| HDL (mg/dL) | Diagnostic |
|---|---|
| 35 - 65 (Men), 35-80 (Women) | Normal |
| Total Cholesterol / HDL ratio | Diagnostic |
|---|---|
| Less than 5 | Good |
| Less than 3.5 | Very good |
| Triglycerides / HDL ratio | Status |
|---|---|
| Less than 1.0 | Optimal |
Glucose Spike and Insulin Resistant
Glucose spikes when we eat lots of carbs from starchy foods (rice, bread, potatoes, etc...),
processed foods, and sweet foods. New York Times food critic Pete Wells
quits the position because of the poor metabolic health consequence.
Glucose spikes occur even for non-diabetic people as discovered in a 2018 Stanford research
Goddess Glucose on Glucose Spike
Too much glucose spikes can lead to insulin resistant. When the body can
no longer use insulin to regulate glucose, A1c will increase.
Dr Boz Getting rid of insulin resistant
Dr Berg How to Reverse Insulant Resistant
Dr Berry Heart Attack Causes Revealed! (And what you Can Do)
Dr. Ovadia Heart Surgeon’s TRUTH about Carnivore Diet & Cholesterol
How we gain weight from excessive carb consumption
Body breaks simple carbs into simple sugars and then mebotalizes into glucose.
Finally it converts to glycogen (strings of glucose) for easier storage. 80% is
stored in muscle and 20% in liver. When we eat too much carbs, the body converts excess glucose into fatty acids
and store in fatty cells in the subcutaneous (underneath the skin) and visceral (around internal organs) regions.
Eating too much carbs and sugars will lead to weight gain. Dr Robert Lustig uncovering
The SHOCKING realities of obesity and skinny fat.
Energy sources for the body
The human body operates like a hybrid car. It has two sources of fuels including clean energy (electric/ketone) and dirty energy (gasoline/glucose).
Either Glucose (carbohydrates & sugar) or Ketone (fats) can be used on demand. Ketones are a type of chemical that the liver produces when it breaks down fats. It's the best fuel source. Fats derive from either the foods we eat or the subcutaneous and
visceral storage.
Glucose will always be deployed first. When the supply is low, the liver produces ketones from body fats for fuel. To illustrate the working
mechanism, I conducted the following experiment:
1) After an overnight 14-hr fasting, I wake up and go to the gym. A 20-min walk on the StairMaster at speed 6 is performed. After the
exercise, ketone is at 2.9. Since I have not eaten, the work out is fueled by ketones.
2) After lunch (steak, avocado, artichoke soup), I wait for couple hours before heading to the gym. Another 20-min walk on the StairMaster
at speed 6 is performed. After the exercise, ketone is still elevated at 2.8. Since not much carbs has been consumed, the body
continues to run on ketones.
3) After dinner (homemade shrimp Chipotle bowl with black beans,grilled onion&bell peppers,lettuce,avocado,sour cream, and tiny bites of Keto blueberry & cream cheese muffin),
I wait for couple hours before going to the gym, Another 20-min walk on the StairMaster at speed 6 is performed. After the exercise, ketone
drops to 0.9. Because the meal contains more carbs, the body uses glucose to fuel my exercise. As a result, not much ketones
are created.
4) After an overnight 14-hr fasting, the next day I wake up and go to the gym. A 20-min walk on the StairMaster at speed 7 is performed. After the
exercise, ketone reading is 2.5. Once again, the work out is fueled by ketones because I have not eaten.
Fatty Liver
Too much fatty cells causes fatty liver. The inflamation over the years leads to
liver cirrhosis. Fortunately fatty liver condition is reversible. But cirrhosis is not.
A healthy liver should have ALT level under 30 IU/L in men and 20 IU/L in women.
To reverse fatty liver and/or insulin resistant, eat good carbs and avoid all bad carbs. When glucose
is depleting due to limited carb consumption, the body goes into plan B. That is
to convert existing fatty cells into glucose for source of energy. This process
is called Ketosis. Keto, Low Carb or Carnivore diets promotes Ketosis.
Being in Ketosis is only meaningful if the body is Fat Adapted as explained by Dr Robert Cywes.
Low-Carb Diets
There are well known low-carb diets including Keto, Low Carb and Carnivore.
Keto consumes daily total carbs less than 20g. Low Carb diet is daily total carbs less than 100g. Carnivore (meat only) consumes 0 carbs. Greater than 325g of carbs
consumed daily is consider excessive for any diet.
Keto aims for the following macro:
Carbs: 5% of calories or less
Proteins: 20-25% of calories
Fat: 70-75% of calories
Net carb = Total Carb - Fiber
For example: Trader Joe Almond Nut Butter
Carb = 7g
Fiber = 4g
Net carb = 3g (7-4)
For this example, the total carbs is 7g, not 3g.
Significant weight loss (10-15bs) is observed during my first 3 months of
Low Carb diet. It's critical to eat enough fats for compensation. Otherwise weight
loss and body thining will occur.
Carnivore Diet
It's the ultimate elimination diet and most effective for people in reversing their metabolic diseases
including diabetes. I tried the Carnivore diet for two months. It increased the good cholesterol (HDL) significantly.
Total cholesterol and bad cholesterol (LDL) also increased.
This phenomenal is known as the
Lipid Energy Model. For lean & healthy individuals,
carbohydrate restriction upregulates systemic lipid trafficking
to meet energy demands. The takeway is that elevated total cholesterol and bad cholesterol (LDL) does not necessary
mean bad.
There is a common misconception that eating too much
proteins will spike glucose due to gluconeogenesis. This occurs for some Carnivore eaters including myself during the 2-month testing. The reason for the spike is due to inadequate fat consumption while eating a very carb-restricted diet.
How to lower A1c and/or weight loss
Step 1: Using CGM
Continuous Glucose Monitor (CGM) such as Abbot Labs Libre3 or Dexcon G7 helps us to see how foods spike glucose in real time for up to 2 weeks. Without wearing it, we just eat blindly.
CGM measures the glucose from the interstitial fluid beneath the skin. Sensor
Glucose data is delayed comparing to Blood Glucose (BG) which draw blood from finger
pricking (glucometer).
How CGM work
Glucometer is not an effective tool because you simply can't prick the fingers
many times a day.
How to apply Libre3. A smartphone (Android or Iphone) is required for data collection and real time graphing. The data is uploaded automatically to Abbot Labs cloud-based diabetes management for information sharing with healthcare professionals and patients.
Step 2: Watch Insulin Resistant short videos on eating and post glucose spikes
Watching Insulant Resistant Short Videos help us to understand how foods affect the blood glucose. Vietnamese dishes tend to have high carb load despite healthy amount of veggies. A half portion of a broken rice dish (Com Tam Bi Suong Cong) spikes my mom glucose by 145 points
My mom glucose data collected using Libre3 and Dexcom G7. Some entries are from me.
Breakfast Start Peak Glucose Spike
8oz hot water & ACV 143 134 -9 G7
1 med avocado & 1tbps peanut butter 134 150 16 G7
Supergreen & 1 egg & 1/2 L avocado 123 146 23
Oxtail soup, half avocado,ras+blu 118 158 40
Fage Stranded Greek Yogurt 116 176 60
rasberry*blueberry
Fage Stranded Greek Yogurt 105 174 69
rasberry*blueberry*chia seeds
Cherios with Almond+coconut milk 120 210 90
and some rasberries
Milk Start Peak Glucose Spike
Almond milk (1 rice bowl) 137 143 6 G7
Unsweetened original
Almond milk (1 cup) 110 118 8 Libre3 (Jeff)
Unsweetened original
Half and half 113 118 5 G7
Sua dau nang (1 rice bowl) 126 139 13 G7
Unsweetened
Premier Protein 30g protein 127 146 19 G7
Premier Protein 30g protein 86 95 9 G7 (Jeff)
Lactose milk (1 rice bowl) 139 209 70 Libre3
Oat milk (1 rice bowl) 112 190 78 Libre3
Juice (G7) Start Peak Glucose Spike
Artichoke juice (1 rice bowl) 138 150 12
Enso supergreen (4oz) 119 137 18
1/2 cup of beet juice 136 159 23
5z sugarcane & kumquat 114 208 94
1 whole fresh coconut juice (no meat) 102 216 114 Libre3 (Laura)
**consumed on empty stomach**
Side dishes Start Peak Glucose Spike
Boiled peanut (1 rice bowl) 127 133 6 G7
Gao lut 3 co gai (2/3 bowl) 120 172 52
Sweet potato (1/2 size) 103 158 55
Purple jam (1) 118 200 82
Lunch/Dinner Start Peak Glucose Spike
Salmon belly & cod fillet 116 122 6 G7
Broiled brocoli, sauted
A little Mediterranean salad (mixed green, tomatoe, 1 large avocado, feta crumb, virgin olive oil)
Bun bo hue with shirataki noodle 126 143 17 G7
Costco Salmon 128 146 18
1/2 small sweet potato, Brussel sprouts
NY Rib eye steak 131 150 19 G7
black bean, cauliflower, brussel sprouts, kale
Wild caught salmon & fish fillets 139 159 20 G7
Mediterranean salad (1 medium avocado, 2 olives, 1 oz feta crumb, virgin olive oil)
1 rice bowl of artichoke water
Wild caught salmon & 3 scallops 132 153 21 G7
Kirkland individual bag & green vegetables & steamed Brussel sprouts & steamed cauliflower
Drank 1 rice bowl of artichoke water 30 minutes before the meal
Costco roast beef & turkey 128 149 21 G7
1 Keto slice bread+provolone, green salad+tomato,boiled eggs, avocado,feta & extra virgin olive oil+lemon + 1/2 artichoke water
Laura abalone soup (1 bowl) 121 148 27
Soup only, no abalone
**drop glucose quickly to 103
Hu tieu bo kho (half) 121 150 29
Soup only, no nooodle
Costco garlic drumstick (3) 109 140 31 G7
1/2 large avocado, steamed Brussel sprouts & Cauliflower
Wild caught salmon & 3 scallops 132 165 33 G7
Kirkland individual bag & green vegetables
One In&Out double double 116 150 34
Protein style, extra onion, no sauce
**small spike and quick drop to 105 due to BF oxtail soup?
Mom oxtail soup (1 soup bowl) 122 158 36
carrot,artichoke
**drop glucose quickly to 93
Kirkland beef lasagne 143 180 37 G7
1/8th portion, fresh baked
Banh mi xiu mai 125 163 38 G7
No bread, 4 beets, 1/2 cooked artichoke heart
Subway #30 the beast 134 175 41 G7
pepperoni,salami,turkey,ham,roast beef, lettuce,tomato,onion,olive
Oroweat Keto 1g bread (2 slices)
Banh mi xiu mai 125 169 44 G7
No bread, 4 beets, 1/2 cooked artichoke heart
Costco garlic chicken (3 legs) 125 176 51
beet, Brussel sprout, Dai Thanh sweet potato (1)
Mom oxtail soup (1 soup bowl) 115 173 58
carrot,artichoke,abalone, 5-6 brussel sprouts, 1 slice of apple
**drop glucose quickly to 89
Mom oxtail soup (1 soup bowl) 106 168 62
carrot, artichoke and two roasted duck slices
**drop glucose quickly to 112
Mod veggie pizza (2 slices) 106 182 76
Banh mi xiu mai 117 198 81 G7
Mod veggie pizza (2 slices) & 116 201 85
tiny tiramisu
Laura abalone soup (1 bowl) 128 228 100
Soup only, no abalone, 2 oxtails, 2 livers, 1/2 large sweet potato, 1 Asian pear slice
**drop glucose quickly
Hu tieu An Khang kho (half portion) 228
Com tam bi suong cong (half portion) 110 255 145
Hu tieu bo kho (half portion) 133 289 156
Snack/Desserts Start Peak Spike
1/2 tangerine 111 119 8 G7
Aunty Sandy banana bread 134 157 23 G7
1 small slice
Buckley's Lozenges (1) 123 166 43 G7
Xam (1 pouch) 104 150 46
Apple Tartar 105 154 49 G7 (Jeff)
1 and 1/4 slices
150g home pomelo 93 142 49 Libre3 (Laura)
Nansui china Asian pear 101 151 50
6 pieces ~ 2/3 fruit
Step 3: Learn about foods that are bad for Pre/Diabetes15 Worst Foods For Diabetics
9 Fruits You Should Be Eating And 8 You Shouldn’t If You Are Diabetic
Dr Gundy rating on exotic fruits
Dr Gundy Are you eating too much apples?
Foods that are high in the Glycemix Index (GI) will cause greater glucose spike. A list of commonly eaten foods and their GI ratings
Step 4: Learn Glucose Goddess 10 eating hacks1. Eat veggies, then proteins fats then carbs and sugars
2. Add veggie starter: raw veges, cooked, etc with dressing. A whole plate of it!! 30% of volume of meal.
3. Don’t count calories. Focus on keeping glucose levels even. Less hunger.
4. Savoury breakfast. Protein, yoghurt, nuts, meat fish, fat and fibre. Nothing sweet.
5. All sugars behave the same; all create a glucose spike. Eat what you like.
6. Pick dessert over sweet snack. If stomach is empty, glucose causes spike, then a crash. After meal, food will slow down sugar absorption.
7. Vinegar 1 tbsp in glass of water before meals changes spike by 30%. Apple cider vinegar, etc all work. Can also be used in dressing. Capsules and supplements don’t work. Antispike supplement may be a good alternative.
8. Move after eating. 10 minutes of movement within 90 min of eating. Calf raises will do it!!!
9. Savoury snacks between meals. Cheese on toast, sugar only after meals.
10. When you eat any starch, add protein, fat or fibre. Eg chocolate cake + yoghurt, pasta + cheese, etc.
A real world test result from using Glucose Goddess food hacks.
Step 5: Start Low Carb, High Fiber or Keto or Carnivore diet
For Vietnamese viewers, here is an excellent guide in starting a low carb diet.
Use Keto bread/tortilla such as Hero brand instead of white bread/regular tortilla
Hero Bread Review
Use Konjac noodle for Vietnamese noodle dishes such as Pho, Bun Rieu or Bun Bo Hue. Available at Asian supermarkets such as Ranch 99 or Dai Thanh (North CA). Buy made in Japan brand.
Make Keto friendly noodle/rice wrapper/dishes from Keto Asian Flavours Youtube channel
Replace regular table sugar with Allulose
Dr. Gundry Sweetener Showdown
Dr Gundy Sweeteners & Gut Health
Step 6: Increase fiber consumption
Dietary fiber is the portion of plant-derived food that cannot be completely broken down by human digestive enzymes. Inside the small intestine, fiber acts like a mop that prevents glucose and cholesterol from attaching to the intestinal wall.
Dr Clayton Guide to lower blood sugar by 60%
Step 7: Take Berberine or Fiber (preferred) supplement if you can't eat enough fiber (Optional)
Step 8: Intermittent Fasting
Intermittent Fasting is an effective tool to manage Blood Glucose and Ketosis. Autophagy allows your body to break down and reuse old cell parts so your cells can operate more efficiently. Even though Blood Glucose might fall below the lower limit, autophagy is induced when the body is already fat adapted.
As an experiment, I tried Intermittent Fasting for 4 straight days. Only 2 meals are eaten daily (big breakfast and dinner, no snacking in between meals). Here are my morning weights after waking up:
Day 1: 154.2lbs
Day 2: 153.8lbs
Day 3: 153.4lbs
Day 4: 152.6lbs
Intermitten fasting while on a Low Carb, High Fiber diet reduced body weight every day. After 4 days, I stopped to prevent further weight loss.
In mid December 2024, I restarted Intermittent Fasting daily with eating window from 11AM to 6PM (17Hr Fasting). In addition, a 36hr fasting period was done during Christmas. Step 9: Schedule Fasting Lipid Panel and Fasting Glucose blood test every 3 or 6 months
Step 10: Check Ketones level regularly
You can use either Ketone Urine Test Strips or Blood-Ketone Meter such as Keto-MOJO or KetoBM to check for nutritional ketosis state. The former requires color matching which lack precision. Furthermore, urine strips only measures excess ketones to be excreted.
Blood-Ketone Meter is the Gold Standard is Ketone measurement. It measures beta-hydroxybutyrate, a ketone body synthesized in the liver, and the most active form of ketones in blood. Here is the Blood Ketone Level for KetoBM device:
| Blood Ketone Level | Ketosis State |
|---|---|
| 0.0 | Valid reading, meter does not detect ketones. |
| 0.1 to 0.5 | Body is starting to produce trace amounts of ketones, but you are not in ketosis quite yet |
| 0.5 to 1.0 | Nutritional ketosis starts. You may start seeing diet benefits and improved energy levels. |
| 1.0 to 2.0 | Optimal Nutritional Ketosis. This is the ideal target range for most people. Your body is burning fat for energy. Many people also experience optimal mental and physical performance at this level |
| 2.0 to 3.0 | Post Exercise Ketosis. In this range, you will likely not notice any additional benefits or detriments compared to the previous 1.0 - 2.0 range. |
| 3.0 to 5.0 | Starvation or Fasting Ketosis. Maintaining these levels consistently should not be a long term goal for nutritional ketosis. |
| Above 5.0 | It is an unlikely reading to result from the keto diet alone without fasting or supplements. There may be an issue with your test strips. Try a new strip (preferably from a different vial) and contact support. Seek medical attention if you aren't feeling well. |
| Above 20.0 | Diabetic ketoacidosis, also known as DKA, is a serious complication of diabetes. If the body makes too much ketones at once, the buildup damages your body and makes your blood too acidic, which is called ketoacidosis. This mainly occurs in Type 1 diabetes. |
My Results
1) A1c drops after 3 months of strict Low Carb, High Fiber diet (no cheating days)
2) Cholesterol and triglycerides drops significantly at the same time
3) Weigh loss occurs at the same time
If bad carbs are consumed, A1c might increase. This is why fasting glucose blood
test should be done every 3 months. This help us to monitor the progress and
make necessary diet adjustment(s) if needed.
5/27/23:
A1c recorded at 6.2
Cholesterol at 220
Triglycerides at 203
HDL (Good Cholesterol) at 45
LDL (Bad Cholesterol) at 134
Trig/HDL ratio 4.5 (203/45)
End of May: Low Carb, High Fiber diet began
9/19/23:
A1c dropped to 5.8 (7% reduction)
Cholesterol dropped to 188 (15% reduction)
Triglycerides dropped to 81 (60% reduction)
HDL (Good Cholesterol) at 46
LDL (Bad Cholesterol) at 126
Trig/HDL ratio 1.7 (81/46)
Lost roughly 12lbs
12/19/23:
A1c dropped to 5.7
No Fasting Lipid Panel blood test
3/19/24:
A1c jumped to 5.9.
Note: Glucose spiked because I was fat adapted but not eating enough fats while eating more proteins.
No Fasting Lipid Panel blood test
3/21/24:
Wearing the CGM again. Snapshot of my daily glucose graphs from strict Low Carb, High Fiber diet
6/19/24:
A1c dropped to 5.8. Gained back 10 lbs from eating more proteins
No Fasting Lipid Panel blood test
7/19/24:
Test the Carnivore diet
9/19/24:
A1c increased to 5.9
Note: Glucose spiked because I was fat adapted but not eating enough fats while eating too much proteins.
Cholesterol skyrocketed from 188 to 266.
Triglycerides increased from 81 to 93
HDL (Good Cholesterol) skyrocketed from 46 to 64
LDL (Bad Cholesterol) skyrocketed from 126 to 183
Trig/HDL ratio 1.4 (93/64)
Note: My 60-day Carnivore diet has provided the lowest Trig/HDL ratio.
Note: Triglycerides increases at a modest pace because my fat consumption is insufficient. For compensation, the liver creates more to meet the energy demand.
Note: This lipid panel result is consistent with the Lipid Energy Model
9/19/24:
Switched back to the low carb, high fiber diet
12/19/24:
A1c remains at 5.9.
Note: Turn out Red Blood Cell (RBC) has life span up to 140 days. Giving this fact, Glucose Blood test is best done every 5-6 months interval when on the Carnivore diet
Cholesterol dropped from 266 to 232.
Triglycerides increased from 93 to 119
HDL (Good Cholesterol) dropped from 64 to 54
LDL (Bad Cholesterol) dropped from 183 to 154
Trig/HDL ratio 2.2 (119/54)
Note: The drop in HDL really show why the Carnivore diet is the Proper Human Diet
Note: Triglycerides increases at a modest pace because my fat consumption is insufficient. For compensation, the liver creates more to meet the energy demand.
12/20/24:
Wear Libre 3 CGM again to track BG again and extend fasting period to 17HR (6PM to 11AM)
12/25/24:
CGM reports GMI at 5.7. The next official blood test should reflect the A1c reduction.
12/31/24:
Morning ketone level after 12-Hr fasting is 0.8.
1/1/25:
24-Hr Fasting ketone level is 2.1.
1/2/25:
Morning ketone level after 12-Hr fasting and 15 minutes StairMaster at speed 8 is 2.5.
1/5/25:
My latest Libre3 data after wearing the CGM for 2 weeks. At Average Glucose of 101, it's a significant improvement after nearly two decades of lab results.
Q/A
1) Where can I purchase CGM?
Unfortunately doctors in the US cannot prescribe Abbott Labs Libre3 Dexcom G7 CGM unless the patient is already Type 2 diabetes. But the device can be purchased without a prescription online or through Facebook marketplace (cheaper).
In late 2024, both companies have released lowered cost CGM that can be purchased over the counter. Abbotts Labs Lingo can be purchased here.
2) Do I really need to wear a CGM?
Absolutely yes. The device is an eye opener and the best investment for your health.
3) Can I still enjoy unhealthy foods?
Eating is one of life greatest pleasures. You can have cheat meals. After waiting 2 hours for digestion, exercise on the StairMaster or Threadmill at moderate intensity. That will reduce BG significantly.
4) Best exercise to reduce Blood Glucose spike after a meal?
From personal experiences, the best exercise is walking on the StairMaster at high speed after a meal. It reduces Blood Glucose significantly.
These are my results after lunch and dinner. Note the exercise is performed roughly 2 hours after eating.
Here is a study showing glucose and insulin improvement from a moderate-intensity stair walking.
5) Have I taken any supplement(s) such as Berberine?
No. My goal is to reverse the condition naturally.
6) Why some doctors are against the Keto diet?
There is still a misconception among healthcare professionals that Ketosis can lead to Ketoacidosis.
7) The mistake I made under the Carnivore diet
When the body is fat adapted, it's important to replenish this energy source with more dietary fats. This
is crucial when you have a low Body Mass Index (BMI) while being very active. Otherwise, significant weight
loss will occur as body fats are converted into lipid cells for energy.
8) Why do I feel very thirsty or experience dry mouth or leg cramps when eating a very low carb diet?
When carbs and sugar are eliminated from diet, insulin levels drops and the kidney releases stored sodium and water. As water exists, we feel more thristy or experience dry mouth. In addition, electrolyte imbalance might cause leg cramps.
9) My CGM reports GMI while Lab blood test reports A1c. Are they the same? Which is better?
Your GMI is calculated from your average CGM glucose, which measures glucose in interstitial fluid (under the skin) every 1–5 min. Laboratory A1C is a measure of how much glucose has attached to the hemoglobin in your red blood cells over the life of each red blood cell in 120 days.
In comparing A1c to GMI values, researchers discovered these findings:
Only 11% of people showed less than a 0.1 percentage point difference between their A1C and GMI. This means if their GMI was 7.0%, their A1C was between 6.9-7.1%.
50% of people had differences of 0.5 percentage points or less. This means if GMI was 7%, actual A1C ranged from 6.5%-7.5%.
22% of people had a difference of 1 percentage point or greater, meaning if GMI was 7%, actual A1C was under 6% or over 8%.
According to Dr Edelman, A1c lab result has been known to be inaccurate, and can be affected many different situations such as pregnancy, ethnic background, kidney disease, liver disease, certain blood dyscrasias.
American Diabetes Association (ADA) states that GMI along with the other CGM metrics provide for a much more personalized diabetes management plan.
10) Doctors and the Standard American Diet recommend low fat consumption to avoid clogging the arteries. Is it safe to eat lots of fat on the low-carb/keto diet?
The doctors are both right and wrong. The correct answer depends on the body main fuel source. They are right if your body runs on glucoses. Since fats are not used, excessive consumption will lead to weight gain and artery clogging.
They are wrong when the body runs on ketones (nutritional ketosis state). Not eating enough fats is a very common mistake on keto/carnivore diet.
11) My A1c is normal. Should I be concerned about the Blood Glucose spikes?
The spikes are devastating even for a very healthy individual with a low A1c of 4.8 as shown below:
Ramen bowl: It took 8 hours for BG to return to baseline.
Costco Combo Pizza (2 slices): It took 7 hours for BG to return to baseline.
Spaghetti with red meat sauce: It took 10 hours for BG to return to baseline.
Fresh Coconut water: Drinking on an empty stomach, BG rises significantly. This fructose-induced spike only last for 2 hours before returning to baseline.
Note: Blood Glucose should always return to baseline within 2 hours after eating. When it stays high for a very long time, inflammation could occur.
